? BCC on temple now urgent referral to Max-Fax

My GP first diagnosed a precancerous Actinic Keratosis on my temple 4 months ago and prescribed a course of treatment of 3 weeks of applying Diclofenic gel and said that if that didn't get rid of it, he'd refer me to the Dermatologist. It did seem to have gone with just a red mark where it had been. Then 2 months later another scab appeared so I saw my GP again and he did a 2 week referral to Dermatology and prescribed an immunotherapy cream, (Imiquimod), for me to apply 3 nights a week for a month. During this time I had teledermatology photographs taken of the lesion and have now been referred from the Dermatologist straight to Max-Fax to have the suspected BCC excised. The referral, (which I've read on my NHS App as my letter from Dermatology has not yet arrived), says it needs this removed as a matter of urgency because it is in a 'high risk area'.

I am also immunosuppressed being on Methotrexate injections and Truxima infusions for Rheumatoid Arthritis and there is a definite spreading of the lesion now going up well under my hair with another 'spot' going towards my eye which is really worrying me. It also looks yucky,(my Grandaughter's word), and  weeps on my pillowcase. I found out today that I have a telephone consult tomorrow when I'm hoping they'll tell me what I can  expect. We're due to go on holiday to Cornwall in 4 days time but my husband is saying that we'll come back if there's a date for the surgery!.Not really sure how anybody can help but it feels a bit better, just typing this. Sorry.

  • Hi Hippyginger

    Sorry to hear that youve had to go through all this. Eventually it will be sorted out. Take your holiday to Cornwall as you are not likely to get a date for surgery for several weeks our local NHS has a wait of 9 months for non urgent BCC. Hope your telephone call goes well.

    Ed

  • Thanks for that Ed. The telephone consult is actually from Max-Fax Admissions so heaven knows when I'm likely to get seen to but.....Will definitely do my best to enjoy my Cornish time whilst trying to ignore the itchy, weepy, yucky, scabby thing on my temple

  • Hi Hippyginger

    I hope that they prioritise you and you get your procedure soon. Be careful of your skin in that strong Cornish sunshine when it comes out. UV index is still UV6 between 11.00 and 2.00pm. 

    Ed

  • Have no fear Ed, it's always SPF 50 all the way for me having been born a fair skinned, blue eye redhead. Mind you, the weather's not looking too wonderful for our first week! Still waiting for my phone consult & to be honest, not holding my breath because they haven't added it to my appointments on my NHS App or sent a confirmation text. I know how busy they all are but it's still making me on edge and being glued to my phone everywhere I go today. What will be, will be.

  • Hi Hippyginger and thank you for your post.

    I am sorry to learn about what you have been going through. Your experience sounds very stressful.

    I can understand the urgent referral to max fax team due to the location of the basal cell carcinoma, the fact that your GP has tried various creams to treat the area; and your immunosuppressed status due to your medication for your arthritis.

    Basal Cell Carcinoma (BCC)is the most commonest type of non melanoma skin cancer. It generally takes years to develop in most people. Most people will only need surgery as their primary treatment.

    It's very rare for basal cell skin cancer to spread to another part of the body to form a secondary cancer. Basal cell carcinoma’s are rarely seen as life threatening.

    You may like to read about the different types of non-melanoma skin cancers at our website.

    I can understand that the timing is not the best so close to your holiday in Cornwall.

    You can use your telephone consultation to ask about treatment timelines, what to expect during and after surgery, and if your Rheumatoid Arthritis treatment needs to be adjusted for the procedure.

    I hope you know more soon and everything will be okay

    Please get back to us if you need any more information or support. You may find it helpful to talk things through with one of the nurses on our helpline. The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5 pm Monday to Friday.

    Kind regards

    Tina

  • Oh thank you so much Tina for your response, it's much appreciated. I'm still hoping, (against hope), that I will get this phone consult today but as it's already 3hours past the time I was given, it's looking doubtful. 

    It's as if this thing has gone into hyper-drive though & the fact it's creeping towards my eye is the most worrying thing, which I'm all set to mention when/if this phone consult happens. I also have Sjögren's syndrome & Fibromyalgia & this stress is making all those symptoms worse too. Sorry to sound dramatic & I know that as far as any form of cancer goes, BCC is probably the least one to worry about with so many others suffering much more devastating forms.

    Ah well, I shall carry on trying to sort out which clothes etc to pack into our touring caravan & try to only focus on that for the rest of the day at least.

    Once again, thank you so much for your time.

    Hippyginger x

  • Well the phone call from the Consultant never came! I was checking my NHS App daily and wonder of wonders, 2days after the call should've happened, I had a copy of a letter from the Dermatologist on there, (=\,hard copy apparent in email mail), saying that after 'being seen'!!!!! NOT seen, only teledermatolgy photographs would have been seen by them. Well basically it says that they will be removing this suspected BCC in their outpatient department under local anaesthetic,(which is all I would've been expecting), and that it may require a flap or graft reconstruction though they expect to be able to close this area primarily with dissolvable stitches and that they will be able to discuss the procedure in more detail on the day! No mention, however, of any estimated timeline I'll be expected to wait for the surgery. Having been a nurse way back in the days of gaslight, I do understand the pressures on the NHS and appreciate any time doctors etc. can spare me, but with my immunosuppression and the way this thing is growing even after both the diclofenic gel treatment and the Imiquimod treatment after that,  it is a concern  especially as the latest bit is getting closer towards my eye. Also not feeling too great about the possibility of reconstruction being needed on such a delicate area. Not that I've ever considered myself a beauty, and anyone who knows me will tell you I'm always joking about looking like the back of a bus lol I just want to get rid of this. The scabby, bleeding and sore thing doesn't look too pleasant either lol.

  • Hi Hippyginger and thank you for posting again

    I am glad to hear that you have heard from the dermatology department and are now more aware of how the dermatologist wishes to treat your basal cell carcinoma.

    I appreciate waiting any length of time to be treated is very stressful; especially with your other co morbidities.

    If you haven’t already done so, it may be helpful to voice your concerns with the hospital's Patient Advice and Liaison Service (PALS) 

    In the meantime, all I can really suggest is that you talk about your concerns with your GP. It may be possible for you to transfer to a hospital with a shorter waiting list for surgery. The website my planned care gives you advice on waiting times and local services.

    There is always the option of going private. I'm afraid I don't know how much it would cost. But in most hospitals now there is a Private Patient's Officer who may be able to advise on this further. The Private Health website has information about private hospitals in the UK and may also be able to give you some ideas.

    I hope this reply helps in some way. 

    Take care

    Tina

  • On thank you for that Tina, my next follow up was going to be PALS if I've heard nothing new from Max-Fax by the time I get home from my holiday in Cornwall. It's only because of this being referred as 'urgent' from the Dermatologist to Max-Fax as to my main reason for wanting to chase them up. I'm guessing that my methotrexate and Truxima were also reasons for the urgency. I shall see what transpires when I get back home. At least sun damage doesn't seem to be a problem in very soggy Cornwall for this holiday but am still using SPF50......just in case those UV rays might find me.